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Related Flashcards
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Cards In This Set
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Abstract
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An outline or summary of the diagnostic statement and /or procedures and services performed.
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Acronyms
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Abbreviations, such as ECG for electrocardiography
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Alphabetic Index
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The reference section of teh CPT-4 manual that is used to help find a code or code range
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Bundled codes
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Codes designating procedures or services that are grouped together and paid for as one procedure or service
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Categories (
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Indented one level below a subsection in the CPT-4 coding manual, usually refers to a specific anatomic site or procedures and /orservices
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Category I code
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The primary procedure or service code selected when performing insurance billing or statistical research
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Category II codes
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Special codes that can help providers track revenue and reimbursement
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Downcoding
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A change in code submitted for reimbursement, usually performed by the insurance company. this change generally occurs because the code submitted does not match in some way to the specifications of the insurance company
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Eponyms
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Procedure, services, or dx named after people, such as Mohs' micrographic surgery or Crohn's disease
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Established patient (EP)
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A pt who has been seen by the sme physician oir same group of physicians over time. An est pt becomes a new pt if not seen by the physician or group in 3 years
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Guidelines
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Found at the begining of each of the six sections of the CPT-4. The guidelines define items that are necessary to appropriately interpret and report the procedures and services found in the section
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HCPCS
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Geaktg Care Common Procedural Coding System; level II codes create to suplement procedures and services not covered in the CPT-4
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Modifiers
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Code additions that explain circumstances that alter a provided sercie, or provide additional clarification or detail about a procedure or service
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Patient status (PS)
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The state of a pt as either new or established; appears in the Evaluation and Management section of the CPT-4
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Place-of-service (POS) codes
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Codes that indicate where a procedure or service was performed
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